摘要
目的探讨乳腺血供不对称性增加在诊断同侧乳腺癌中的价值。方法对169例乳腺疾病患者行乳腺动态增强MR检查,在最大密度投影(3D-MIP)图像上进行血管计数,当血管长度≥3 cm且最大直径≥2 mm时,列入筛选合格范围,两侧乳腺合格血管差值≥2个时认为乳腺血供不对称性增加。分析乳腺血供不对称性增加诊断同侧乳腺癌的灵敏性、特异性,以及与浸润性癌病灶最大径及组织学分级的关联。结果病理结果证实恶性病变83例和良性病变43例,其中浸润癌72例和导管内原位癌(ductal carcinoma in situ,DCIS)11例,其余的43例经随访均为阴性。以乳腺不对称性血供增加作为同侧乳腺癌的诊断标准的灵敏性为65%,特异性为84%,准确性为75%,阳性预测值为79%,阴性预测值为71%。在浸润性癌组中的灵敏性与DCIS组相仿(P<0.001)。在浸润性癌组中,病灶最大径越大的组,灵敏性越高(P<0.001)。在组织学Ⅲ级病灶组中的灵敏性高于在组织学Ⅰ级、Ⅱ级病灶组(P=0.013)。结论乳腺血供不对称性增加与同侧乳腺癌相关,尤其在浸润性癌最大径≥20 mm或组织学分级高的情况下。
Objective To estimate the diagnostic value of asymmetric increase in breast vascularity （AIBV） for diagno- sing ipsilateral cancer. Methods A total of 169 patients underwent bilateral contrastenhanced magnetic resonance （MR） imaging. Vessels ≥2 mm in diameter and ≥3 cm in length were counted on maximum intensity projections： a difference ≥ 2 in number between the two breasts was considered AIBV. The sensitivity and specificity of AIBV as well as the association between AIBV and the diameter of invasive lesions or the histological grade were analyzed using Maximum intensity projections. Results Pathology revealed 83 malignancies （72 invasive carcinomas and 11 DCIS） and 43 benign lesions. The remaining 43 patients were negative at follow up. Sensitivity, specificity and accuracy of AIBV in diagnosing ipsilateral cancer were 65%, 84% and 75% respectively. Positive predictive value and negative predictive value were 79% and 71%. Sensitivity in invasive cancers was similar to that in DCIS （P 〈0. 001 ）. For invasive cancers, the greater the Lesions of maximum diameter, the higher the sensitivity （P 〈 0. 001 ）. The G3 lesion rate was higher among true positives than false negatives （ P = 0.013 ）. Conclusion An association between AIBV and ipsilateral cancer was exist, particularly for invasive cancers ≥20 mm or with high pathologic grade.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第6期841-845,共5页
Journal of Clinical Radiology
关键词
乳腺癌
磁共振成像
最大密度投影
诊断价值
Breast cancer Magnetic resonance imaging Maximum intensity projections Diagnostic performance
